Friday, November 30, 2012

How do you feel about midwifery?

I know some of you, from different cloth diapering communities and natural parenting communities.  Some of you may know my dream of becoming a midwife.  I am always interested to hear why people choose midwives or doctors, because curiosity killed the cat I suppose.  I support any woman's choice to go with a midwife or doctor, my only personal feeling is that each woman should be educated into all the possibilities before she has to make a choice.  That is my stance...

That being said, did you use a midwife or a doctor?  Would you do the same or different next time (imaginary or real)?  

I found this blog on and thought it was interesting and thought I'd share.  

My first prenatal appointment with my new OB/GYN went fairly well. She was personable, gave time for answering questions, and talked with me about what kind of schedule I was looking at for tests, etc. I asked about birthing options and she basically broke it down to drugs or no drugs. Induction and/or a c-section was possible, but wholly dependent upon the circumstances of my labor (or lack there of) near term. I didn't really know what else to ask about, so I took my prescriptions for prenatal vitamins and progesterone (I had a history of miscarriages), made an appointment for the next month, and went on my way.

I was really interested in having a water birth, but quickly learned no hospital in Phoenix allowed for water births. However, there was a free-standing birth center that would. Bethany Birth Center (now Bethany Women's Wellness Center) was comprised of two buildings, an office for Women's health care and a birth center where women can give birth in a calm, home-like environment without the aid of drugs or fear of surgery. Better yet, water birth was not only an option but highly encouraged. BBC had four midwives and two OB/GYNs, but the OBs would only deliver in hospital. If I wanted to give birth at the birth center, I would have to become familiar with what exactly a midwife is and does. After about 3 months with my doctor everything seemed to be going well for my pregnancy, so I contacted BBC for my first appointment, all the while reading as much literature as I could about midwives, water birth, and natural birth. I still scheduled my next prenatal appointment with my doctor, just in case I found myself uncomfortable with the birth center.

My first appointment with the midwife was similar to seeing the doctor, and yet different. Instead of urinating into a cup and then sticking into a little alcove for the nurse to take and test, I was given a cup and a test strip, then told to follow the directions posted on the bathroom wall. I tested my own urine for protein and glucose, which meant I knew my status without having to ask later (the doctor, incidentally, had not told me what the urine samples were for). I was weighed and had my blood pressure checked, just as had been done at the doctor, except the nurse encouraged me to write these stats down and keep them logged. I was given a little purple log that would hold the stats for the length of my pregnancy. When I finally got to the exam room it was carpeted instead of tiled and much warmer than the doctor's office. The nurse practitioner saw me and talked to me about what they do at the birth center and the different classes that were offered and required. My doctor did not have birthing classes that ran out of her practice, instead she had referred me to the hospital in which she contracted with. The birth center provided the classes as well as support groups and a 24-hour number in case I had questions or concerns. I had been instructed by my doctor to go to the hospital or call 24-hour nurse line (not associated with her practice) if I had concerns or problems that occurred outside of normal office hours. The difference between the birth center and the doctor came down to a feeling more than anything else. I felt like I was in control of my pregnancy at the birth center and that my voice was important. At my doctor, I felt like just another number with a voice that needed to be silenced when heard. Thus began my prenatal care with nurses and midwives.

When you are pregnant time seems to slow down. Because you are counting every day of every week, you wonder if you will ever make it full term. Birth classes help with the waiting. I attended 5 different classes at the birth center on various things. "Body Works" was a class about what changes happen during pregnancy, labor, and delivery. "Baby Works" taught pregnant moms and soon-to-be-dads about basic baby care for the first three months of life. "Labor Day" included an introduction to all the options available at the birth center, as well as what to expect when you came in during labor. My partner and I also attending a breastfeeding class and a relaxation class. I spent hours putting together a six page birth plan that covered everything from episiotomies to having myself or my partner with our newborn at all times after birth. I read up on everything I could think of related to being pregnant, giving birth, nursing and newborns. When I ran out of new information, I dragged my partner to the hospital tour of the hospital that contracted with the birth center in case of emergency (or patient choice). My partner painted the nursery, my sister threw me a baby shower, and we had just about everything we could possible need to take care of a baby. And yet, after all of this preparing I still felt unprepared.

I was nervous about all the possibilities of labor and birth. I was nervous that I wouldn't be able to nurse for whatever reason, that I wouldn't naturally find myself attached once my daughter was born. Emotionally I was ripping myself to shreds with worry and doubt. At 34 weeks everyone around me was anxious for me to give birth, including my partner. People would ask me if I was ready for to give birth and for pregnancy to just be over already, but I would shake my head and tell them I was enjoying pregnancy and hoped it lasted full-term. I gave excuses like "Never before have I been so healthy and happy" or "She has everything she needs in the womb, why would I want that to end for her?" But really, I was just terrified of becoming a mother, of the new vulnerability that my baby would have once she was naked in this world. Instead of sharing my feelings, I just kept smiling and telling everyone I was in love with being pregnant.

From listening to other pregnant women and mothers, I gathered that on average OB doctors don't ask you about how you feel about being pregnant, and when they ask you how you are they are generally looking for a positive, blanket answer that will not involve them personally. This is not only accepted by most women as normal, but is expected since your OB specializes in female parts and delivering babies, not feelings. But as a pregnant woman I expected a whole lot more from everyone around me, including my prenatal care provider. This is why when the midwife asked me how I was feeling at 36 weeks pregnant, I said I was nervous. If she had been a doctor I imagine she would have told me some stock line like "there is nothing to be nervous about, you are healthy, your baby is healthy, and if anything happens then my staff and I are here to make everything go as smoothly as possible." This answer would have made me even more nervous and uncomfortable, because it wouldn't have addressed why I was nervous in the first place. But I was talking to a midwife, not a doctor, and her reply was a question "why are you nervous?" Suddenly the tears started falling and I realized that I had no idea what all the built up tension was from. So we worked through it. "Are you worried that something will happen to you or the baby?" "No." "Are you worried about being a mother?" "Yes." "Why?" "Because I don't have my mother and I don't really know what mother's do anymore, it's been so long..." BINGO!
We talked for maybe 20 to 30 minutes about my fears and worries, leafing through thoughts that had troubled me in the middle of sleepless nights but had been buried without bothering to talk to anyone about them. The midwife hugged me a few times and gave me an assignment, to express my thoughts and worries through art and bring it in to talk about the next week. I did end up writing, but I never brought it in to show the midwife. Instead we talked each time until I felt better about giving birth and becoming a mom. By my due date, I was anxious to meet our new daughter and ready to begin motherhood.
I started laboring at home the night of my due date, moving into all kinds of positions to deal with the pressure and pain of labor. I labored for three hours before heading to the birth center to meet the midwife. Once at the birth center I labored for another 30 minutes, standing and moving around, until I felt the urge to push. My partner had prepared the bath tub soon after arriving and after reluctantly letting the midwife check to make sure I was fully dilated, I told her I was heading for the tub, striped off the last layer of clothing I had on, and got into the tub to labor another 30 minutes of pushing. My daughter Madilyn was born in the water at 3:33am. My partner Ishmael caught her and lifted her out of the water, then promptly placed her across my chest for warmth. He cut the umbilical cord and I stayed in the water holding Madilyn while I gave birth to the placenta. The only people in the bathroom while I was giving birth were Ishmael and the midwife. There were no monitors beeping or nursing rushing about. In fact the only person touching me was Ishmael, who had his arm around me. Occasionally the midwife checked the baby's progress and told me what she could see and feel. When the baby's head was crowning, she let me know so that I could reach down and feel it for myself. The feeling helped me concentrate and focus on pushing. Throughout the labor and delivery I felt in control. After all, I was the one doing all the work, I should be the one in control of what is happening.
I so enjoyed the birth of my daughter Madilyn that immediately after giving birth I wanted to do it again. During my pregnancy I had told many different people, friends and strangers alike, that this would be my only child, mostly because I was so afraid of labor and delivery. After giving birth I was no longer afraid. If anything, I was motivated. I was home and in my own bed 6 hours after giving birth, resting. For lunch we went to Olive Garden, so I could satisfy my craving for bread sticks, minestrone soup, and endless salad. I cannot imagine giving birth any other way.
Over and over again I have heard horror stories from women who have given birth in a hospital and never again want to give birth. I hear about pushy nurses who are nasty with laboring moms. I hear about doctors who are barely there during labor, some who order cesarean sections after a few hours of labor because they are tired of waiting for the laboring woman to progress far enough to push and some who induce on particular days so that their patient's labor and delivery won't interfere with their golf game or out-of-town vacation. What is common to all of the stories I hear is the feeling of helplessness that the woman felt, of being completely at the mercy of the doctors and nurses. They were told what they could and could not do, and believing that it was out of concern for their health they listened, only to find out it had much more to do with insurance and the "baby assembly line."
The "baby assembly line" is what I call hospital tailored births, because in a hospital birth it is all about protocol. Rather than consider the individual needs and wishes of a woman in labor, they look at her physical stats and proceed from there. Women are not allowed to eat or drink while in labor, no matter how long they have been in labor, just in case the doctor decides to admit the patient for a c-section. Reread that last clause. "In case the doctor decides to admit the patient." An IV is hooked up to every woman in labor to keep her hydrated. She is allowed to have ice chips, but nothing more. In some hospitals she is allowed to walk around while in labor, but once she is dilated past a certain point she is no longer allowed to leave the labor bed. While the midwife was checking my cervix I had to lay down on the bed in the birth center through one contraction, it was the most painful contraction of my entire labor and I was thankful that it was the only one. Many women have to spend their entire labor laying in bed dealing with that kind of pain... which is why many women ask for epidurals. When I consider all of the conditions that a hospital environment dictates to a pregnant woman, it is not surprising to me that so many women are afraid of giving birth, are unhappy with their experiences, and request so much medical intervention to combat what is already being forced upon them.
I am a woman who trusts her body, who listens to the needs of my body, and refuses to deny those needs to satisfy a doctor, or anyone else for that matter. When my body is healthy and functioning in a natural, healthy way, I refuse to relinquish control of my body to anyone. In this way, I take responsibility for my experiences and my happiness. I am more satisfied than most because of it. Pregnancy is a natural process for the female body and should be treated as such until extenuating circumstances change how well the body is prepared for such a complex process. All of the medical inventions that surround birth and labor came about in order to make child birth safer for those women who have extenuating circumstances, NOT to standardize birth so that every woman must endure the samemedicalizations for the sake of time and money.
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  1. I've had 3 births and 3 midwives. For me, that is the ONLY way to go. I've never seen a doctor in regards to my pregnancies. My first birth was in FL. and I delivered in a house that was midwifery center. I loved the personal experience! In some states, midwifery practice is not legal/accepted, so when we moved to VA this was the first thing I looked into when we started talking about having a second baby. The availability of a midwife was the determining factor on whether I would be willing to have a second baby. I refused to have a traditional hospital birth. Luckily we found a great midwifery center and I've had 2 other babies. :) I've never been hooked up to an IV or hooked up to any monitors, or been confined to a bed during labor/delivery. Sure, I didn't have the option of pain medication to aid in the labor process, but it was never an option that I would consider anyways.
    So, I highly recommend going the route of a midwife!!!!

  2. I think midwifery is amazing and a beautiful way to give birth. But also its not for everyone so I'm glad we have so many options now. I'm actually more comfortable giving birth at a hospital but using natural techniques. I had an all natural birth at a hospital for my first and it was the most amazing experience and went exactly how I dreamed. I'm currently pregnant and going the hospital route again. We are planning on having 8 children though and I know at some point down the line I do want to expereince a home birth with a midwife. I'm just not there yet. Good luck with your midwife route!

  3. i wish my midwife could've been more involved in the birth, but she didn't have the certification or whatever to deliver at the hospital. my ob was impersonal and overbooked with other more complicated pregnancies than mine. the nurses at the hospital did everything but the actual delivery and they were awesome :) i won't go back to that ob, she dismissed all of my questions whereas my midwife explained everything and made me feel like a person. i'll have to find a different ob to deliver here again, and since i live an hour from the hospital i'm not quite brave enough to try a home birth next time. that's too far to drive if something goes wrong, but i really wish my midwife could do it all for me.

  4. I had my first child in February 2012. I wanted a natural birth simply because i was afraid of getting an epidural. I had an OB. I was in my third trimester before i started actually researching childbirthand it wasn't until that point i had even heard of a midwife. At that point, i felt like i was too far along to switch doctors. My doctor was nice enough. He offered the usual tests but wasn't pushy when i declined them. However, towards the end of my pregnancy, i had to firmly and repetitively decline inductions; it was annoying. My OB wanted to induce me simply because i was past my due date
    I got what i wanted only because i had done the research and felt comfortable standing up to my doctor; it shouldn't be that way.
    Next time, i will go with a midwife. I don't want a care provider who treats pregnancy like an illness. I feel like a midwife will be on my side and not fight against what my body was designed to do. I'd also like a homebirth if i could talk my husband into it.

    Good luck, i think we could use more midwives!

  5. I agree we do need more midwives. I absolutely love my midwife. I had two hospital births, the second of which ended up in a cesarean. Both times I felt completely out of control. With my third birth, because my Dr. decided not to tell me until my 7th or 8th month of pregnancy that the hospital I was planning to birth at changed their policies and no longer allowed VBACs despite my being perfectly clear that I wanted a VBAC, I took my business elsewhere and went with my midwife. It was one of the best decisions I have ever made.

    My midwife was without a doubt, born to be a midwife. She has the absolute perfect personality for it, she's kind, & compassionate, yet always calm and firm when she needs to be. She bonds with her families and I very much consider her to be a part of mine.

    Sadly not only did we move away from that beloved area where she lives but I've had some serious complications during birth so my last baby was born by scheduled cesarean. I hated it. I wasn't even given the chance to touch my baby until almost an hour after she was born and I guess because I was in a hospital setting and he thought I was taken care of my husband didn't stay with me much while I was there. The baby got jaundice (like all the rest of my babies) and things spiraled out of control. Baby's rising numbers led to bili-lights, formula, pacifiers and a night in the nursery. I got no sleep so I was irritable and emotional. I felt completely outnumbered and abandoned. The post-cesarean antibiotics led to thrush that won't go away, baby's Dr wants to medicate her for reflux and I have an overabundant milk supply. I'd wanted more children but I don't think I can do this again.

    All I can cling to is that at least I got the one tough, yet amazing homebirth experience with my first son and I got to share it with an amazing midwife who will always be very special to me. There should be more midwives so more women can experience kind, compassionate care. Where we're real people rather than just patients.

    That's not to say, of course, that OBs are not compassionate. It's just hard to get to know them when you only see them a few times throughout the entire pregnancy and, if you're like me and my first birth, where the Dr runs in just in time to catch the baby and leaves.

  6. I got what i wanted only because i had done the research and felt comfortable standing up to my doctor; it shouldn't be that way.
    Next time, i will go with a midwife. I don't want a care provider who treats pregnancy like an illness. I feel like a midwife will be on my side and not fight against what my body was designed to do. I'd also like a homebirth if i could talk my husband into it.

  7. In the field of medicine, midwifery is really the most amazing things. To assist the woman to give birth and to see for the first time the babies' cries. There are a lot of option nowadays, may it natural or caesarian thing and that includes surgical issues.

    Any method will do, as long as the baby will come out healthy and safe and as well the mother.

  8. When pregnant with my son I had a doctor. I live in a small town in northern Minnesota and there are no midwives close by. I love my doctor and because we only have one ob in our town I used my general practitioner who I have seen for 8 years. She was at the hospital through most of my labor checking on me often and was also there from the very first push through delivery. Although going in to my pregnancy I had hoped for a midwife I am very grateful that I did not use one because the end ofy pregnancy along with labor and delivery had many complications. Next time I will be using my same doctor but will be hoping for an all natural birth that wasn't possible the first time.